11NUTRITIONALANEMIA22NewwordsNewwordsNutritionalNutritional营养的营养的MegaloblasticMegaloblastic巨幼细巨幼细胞胞HamorrhageHamorrhage出血出血IrritabilityIrritability激惹激惹LethargyLethargy嗜睡嗜睡FatigueFatigue疲乏疲乏AnorexiaAnorexia厌食厌食AppetiteAppetite食欲食欲MicrocyticMicrocytic小细胞的小细胞的HypochromicHypochromic低色素的低色素的ThalassemiaThalassemia海洋性贫血海洋性贫血FerroussulfateFerroussulfate硫酸亚铁硫酸亚铁HookwormHookworm钩虫钩虫EpistaxisEpistaxis鼻出血鼻出血ReticulocyteReticulocyte网织红细胞网织红细胞33NutritionalanemiaNutritionalanemiaMegaloblasticanemiaMegaloblasticanemiavitaminB12deficiencyvitaminB12deficiencyfolicaciddeficiencyfolicaciddeficiencyIrondeficiencyanemiaIrondeficiencyanemiairondeficiencyirondeficiency44IrondefeciencyanemiaIrondefeciencyanemiaIntroductionIntroductionCauseofIrondeficiencyanemiaCauseofIrondeficiencyanemiaClinicalfeaturesClinicalfeaturesLaboratoryfindingsLaboratoryfindingsDiagnosisDiagnosisDefferentialdiagnosisDefferentialdiagnosisTreatmentTreatment55IronDeficiencyAnemia,IDAIronDeficiencyAnemia,IDAIncidenceofIDA:10-70%(WHO)40%(6m-6y，China)66IDAisthemostcommoncauseofanemiaIDAisthemostcommoncauseofanemiainchildhood.inchildhood.ItusuallyresultsfromItusuallyresultsfrominadequatedietaryinadequatedietaryintakeintakeratherthanlossofironthroughratherthanlossofironthroughhemorrhagehemorrhage..77IroninmilkIroninmilkBothofbreastandcow`smilkareBothofbreastandcow`smilkarelowlowininironironIronisbetterabsorbedfrombreastmilkIronisbetterabsorbedfrombreastmilk(50%)(50%)comparedtocow`smilkcomparedtocow`smilk(10%)(10%)FormulamilksarefortifiedwithironFormulamilksarefortifiedwithiron(4%)(4%)88DietarysourcesofironDietarysourcesofiron99DietarysourcesofironDietarysourcesofironRedmeatRedmeatFortifiedbreakfastcerealsFortifiedbreakfastcerealsDarkgreenvegetablesDarkgreenvegetablesBlackbreadBlackbreadabout10-15%ironofdietaryisabsorbedabout10-15%ironofdietaryisabsorbed1010IronrequirementsIronrequirementsThefetusabsorbsironfromtheThefetusabsorbsironfromthemothermotheracrossacrosstheplacenta.theplacenta.TerminfantshaveadequatereserveforthefirstTerminfantshaveadequatereserveforthefirst4months4monthsoflife.oflife.PreterminfantshavelimitedironstoresandPreterminfantshavelimitedironstoresandbecauseoftheirhigherrateofgrowth,theirironbecauseoftheirhigherrateofgrowth,theirironreserveswereusedupbyreserveswereusedupby8weeks8weeksofage.ofage.AdolescentsalsoneedmoreironbecauseofAdolescentsalsoneedmoreironbecauseof1.1.GrowthGrowthspurt2.spurt2.DietaryDietarydeficiency3.deficiency3.MenstrualMenstrualbloodlossbloodloss1111ReferencenutrientintakeofReferencenutrientintakeofironare:ironare:6months:4mg/day6months:4mg/day12months:8mg/day12months:8mg/dayAdultmale:9mg/dayAdultmale:9mg/dayAdultfemale:15mg/dayAdultfemale:15mg/day1212（一）（一）thedecreaseofironstoresthedecreaseofironstoreslowbirthweightlowbirthweightpreterminfantspreterminfantshemorrhagehemorrhageCausesofirondeificiencyCausesofirondeificiency1313CausesofirondeificiencyCausesofirondeificiency（二）（二）NutritionaldeficiencyiscommoninNutritionaldeficiencyiscommonincertainat-riskgroupscertainat-riskgroupspreterminfantsrequireironsupplementspreterminfantsrequireironsupplementsfrom6-8weeks.from6-8weeks.TerminfantswilldevelopirondeficiencyTerminfantswilldevelopirondeficiencyafter4monthsifafter4monthsif1.mixedfeedi...
